073404256-1-6-2022-02-CC-CACA-CAESPQ-20220106130332

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073404256
Report Date: 01/06/2022
Date Signed: 01/06/2022 01:04:17 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	ALICEA, DEBBIE		FACILITY NUMBER:	073404256
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	01/06/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Debbie Alicea		TIME COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Cherie Acosta conducted an INCREASE IN CAPACITY/CASE MANAGEMENT INSPECTION by use of FaceTime. An in person inspection was not conducted due to the COVID-19 pandemic. LPA met with Debbie Alicea. Licensee has an approved fire clearance for up to 14 children. Fire clearance indicates childcare is not to be conducted on the second floor or garage. The home was toured for a Health and Safety Inspection. This home is a two story home. The first floor consists of a living room, den, family room, kitchen, dining room, bathroom, laundry room and garage. The second floor consist of four bedrooms, two bathrooms and a bonus room. The home was observed to be neat and clean. The on limits areas used for child care are the living room, den, family room, kitchen, dining room, and first floor bathroom. The entire second floor, laundry room, garage and backyard are off limits to children. Off limits areas will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be family room. Licensee uses the front yard for outdoor play. Licensee is aware that 100% supervision is required during outdoor play as the front yard is not fenced. There are age appropriate toys in the home. This home has a pool. The pool is made inaccessible to children by use of a fence with a self closing gate that opens away from the pool. There are no firearms in the home as stated by the licensee. LPA did not observe any hazardous materials or toxins accessible to children today. The home is equipped with a working smoke detector and carbon monoxide detector. There is a working telephone in the home. The home has a fully charged 3A40BC fire extinguisher. The home has a gas fireplace that is not used during child care hours as stated by the licensee. Stairs are gated. Licensee has current CPR/First Aid which expires 06/2023. Licensee completed mandated reporter training 10/20/2021. Licensee is in compliance with required immunizations. Safety precaution in regards to COVID-19 were discussed with applicant.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ALICEA, DEBBIE	FACILITY NUMBER: 073404256
	VISIT DATE: 01/06/2022

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The increase in capacity is approved as of today 1/6/22.
Exit interview conducted and report reviewed with Debbie Alicea.
Report will be emailed to licensee for signature. Licensee agrees to sign and return the report to CCL by 1/6/22.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022

LIC809 (FAS) - (06/04)

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